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- Case Report -

A Case of Non-mucin-producing Well Differentiated Papillary Adenocarcinoma of the Lung With a 12-Year Clinical History Before Operation

Yoshihisa Inage¹, Masaaki Sumi², Masachika Fujiwara³, Tatsuo Yamamoto⁴, Shigemi Ishikawa⁴, Masataka Onizuka⁴
Department of ¹Thoracic Surgery, ²Internal Medicine and ³Pathology, Kensei General Hospital, Japan, ⁴Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan

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Background. There have been very few reports of slow-growing adenocarcinomas, all of which consisted of bronchial gland cell type or goblet cell type with mucin-production. We report a case of well differentiated papillary adenocarcinoma without mucin-production and a long clinical history before operation. Case. A 75-year-old woman was admitted to our hospital because of bloody sputum and an abnormal shadow of the left lung. The shadow had been pointed out 12-years previously, nevertheless, she had not received a detailed examination. Chest CT showed a consolidation, measuring 7×4×3 cm in size, in the left S⁴. The lesion was diagnosed as adenocarcinoma by transbronchial biopsy and brushing cytology, and left upper lobectomy with nodal dissection was performed. Histologically, most of the tumor showed bronchiolo alveolar growth without fibrous scar formation, but the central part, measuring 1.5 cm in diameter, showed papillary growth of cancer cells which resembled bronchial surface epithelial cells and Clara cells without mucin-production. Conclusion. Our case was a rare slow-growing adenocarcinoma with bronchiolo-alveolar growth, non-mucin-production and a long clinical history before operation.
key words: Lung cancer, Non-mucin-producing, Well differentiated papillary adenocarcinoma, Bronchiolo-alveolar carcinoma (BAC), Slow growing

Received: October 26, 2001
Accepted: December 17, 2001

JJLC 42 (1): 35-40, 2002